“We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.”

So, Salim argues these documents, "as read and understood through modern sensibilities" provide a right to health care. [More...]

In other words, he argues, in this day and age, "the government’s charge to promote the general welfare, coupled with every person’s right simply to live, more than implies a right to health care - it demands a right to health care."

The comments to his article are interesting, especially this one from a physician:

I have no angry comment. I merely disagree with you. The U.S. Constituton [sic], in fact, does not give citizens the right to health care any more than it gives them the right to an automobile. You may honestly believe you have an essential “right” to my or my colleagues’ services, but I assure you, that is currently not the case. And in my case, since no one can actually force me to provide you with my services against my will, you will, in fact never, ever, have a right to my services as a physician. My services are available, but will never be on that basis. You have no more a right to them than I have the right to your services as a journalist.

If Heath care someday is legislated to be a right, it clearly would have to come with resonsibilities [sic] most people don’t take. A right like that has to be deserved.

the good doctor and I appear to agree is that along with rights there should be an understanding that you also have responsibilities.

IE If there is the expectation that every pregnant woman give birth then the government has a responsibility, to feed, educate, provide shelter and health care for those individuals they are MANDATING be bought into this world. If you are going to make personal decisions for people then you have a responsibility to help them deal with the consequences of those decisions you made on their behalf.

If you believe in national defense, roads or bridges, food safety, water safety, drug safety, then you have a responsibility to fund these things with taxes etc, etc.

It's just too darn bad it's politically unacceptable to say these things to people. Instead we are supposed to vacciliate.

And in my case, since no one can actually force me to provide you with my services against my will, you will, in fact never, ever, have a right to my services as a physician.

CURRENTLY under law if I go to an emergency room without insurance, aren't there laws that force physicians to proved treatment? If I come in bleeding to death can they let me bleed out on the floor if they feel like it?

scholar, but I have struggled with the peculiar about ownership of medical competency and the reasoning we use in making health care policy and related policy decisions based on the underlying and unconscious assumptions about who owns that knowledge.

I have come to the conclusion that the issue of regulation of health care and licensing of physicians is ultimately an important part in the debate.

This is not the only way the idea can be used, but to this arrogant doc who talks about his "services" as if they are simply his property, when in fact he was more than likely educated and trained at substantial government expense (even if he payed private tuition), I would say this: fine! Then let us have access to all the drugs and equipment which are legally limited to your use and sale, and we will take care of ourselves. What's mister "I own it all" got to say in response to that?

and accurate medical information increasingly available on the internet, the "ownership" of medical knowledge is no longer exclusive. I can look up symptoms, diagnoses, many images including CT scans, X rays and MRIs. I can find studies, read case studies, morbidity/mortality reports, check out the latest research and drug trials.

It doesn't mean that I am trained or qualified to practice medicine on other people, but it does mean that the doctors don't hold all the cards, even though they may hold the keys in terms of ordering tests and prescribing drugs.

argument, which I have been constructing the various aspects of for some time, I usually ask that people suspend -- only temporarily -- the competency question. Other things can be considered without considering that first. I know the idea sounds bizarre, irrelevant, and senseless; but it actually sounds that way because we are "trained" to ask the competency question first, and then to stop any further exploration based on the "doctor-knows-best" fable. I believe my argument is actually the thread that could unravel a whole web of issues ranging from drug prohibition to public healthcare, and several other enduring social problems. It is the hidden common denominator of several irrational systems which we have historically accepted as rational, but we are now confused as to why everything has all fallen apart under the pressures of the real world. I hold that it is because of the closed professional system we have allowed a self-interested professional community to build around a commodity that is extremely important to us all.

In playing with this idea, I generally don't get into the competence debate at all (e.g. the question of whether or not people who don't have formal degrees or training be competent physicians). I leave it to others. I am not saying it is unimportant. I am just saying that it doesn't preclude the examination of other consequences of deregulating medicine. The competency issue is not ultimately relevant to my underlying argument. We are "trained" to put that question first, and to stop the debate in its tracks after our doctor-knows-best belief kicks in and shuts down further thought on the subject (for once, although I know we aren't used to it, don't ask your doctor if this argument is right for you -- try it for yourself first!).

I am not asking you to forget your idea, or to agree that competency is not important. I just ask you to temporarily suspend the concerns that you have about whether or not someone who doesn't have a medical degree or license can be technically competent as a provider, then come back to it later. You can reserve the right to reject my argument based on the competence issue later. All I request that you suspend judgment on that issue long enough to be able to give a fair hearing to all the fascinating truths and novel perspectives that fall out once the doctor-knows-best barrier is removed.

If health care is a commodity, and we have no right to demand it from those licensed to provide it, then we must, under any honest and sincere version of capitalistic reasoning, have the right to make it at home for ourselves.

doctor doesn't always know best, or Michael Jackson's doctor would have rushed him to the emergency room.

There is a difference between rigorous training and mere knowledge. Experience helps too, but even that isn't always enough. I've seen both sides of the coin, from seeing one child successfully diagnosed with a rare disease after almost 24 hours of doctors working frantically to another child who was not diagnosed after over a week of worried parents consulting various doctors. (The difference? A pediatric specialty hospital versus GP and emergency room physicians.) The other side was telling medical professionals about Pott's Puffy Tumor and none of them recognizing it. (It's an abcessed sinus infection.)

This is when I started realizing that medical professionals can't know everything - and that I am probably the best specialist my family can have. I don't need to consult a chart to remember who had what and when.

Priviledge? We are the only country among the
industrialized and civilized nations that does not consider protecting its citizens as one of the essential elements in a democratic society.

We can parse the constitution and the bill of rights forever, but we rank 37th in the world regarding healthcare.

If we aren't smart enough to understand the moral and practical elements of providing affordable healthcare and drugs to our citizens we will begin to become irrelevant as a result of capitalism gone beserk.

Obama has allowed republicans to frame and control the debate by not being clear and instructively lucid as to exactly what he's talking about. Obama sounds like he's winging it and is looking for political cover as congress thrashes out....nothing. This is not leadership.

I also don't see the point of bringing a constitutinal debate into this issue.

Insurance companies have no constitutional right to their profits. It is a priveledge and that priveledge can be taken away by the government that grants them a lisence to do business if they don't adhere to things the government deems necessary for a stable and secure society.

Same is true for doctors, although i know a lot of doctors who actually do care about a stable and secure society.

I know of no insurance companies that do care about much of anything at all but profits.

"We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness."

the more i dwell upon it i'm utterly delighted by how they sneak "pursuit of" in there before happiness. But that leads me to actually side somewhat with Salm on this.

first of all let's break it down... what's the goal? a more perfect union.

basically when it comes to happiness, you have the right to pursue it but don't show up at Jefferson's door if you're not happy. people can be unhappy in a more perfect union.

This leads me to believe that a brilliant distinction was made if only sub-consciously. in contrast, if you are denied life or liberty then america is failed in it's goal to form a more perfect union.

I still think it's wrong to impose this current debate onto the constitution because I think the declaration of independence was written to address the possibility of foreign invaders from other countries. it makes sense to me that they wrote "right to life" because they wanted to give people the reasonable expectation that if they were attacked and their lives were threatened by agents foriegn or domestic that government was formed with the primary objective of protecting them and preserving their right to life.

same with liberty for that matter.

i can't argue right to health care is in the constitution. what I can say is I think Jefferson and the framers of our constitution would have a negative perspective about someone who believes all men are not created equal in the eyes of a health care system.

it doesn't say: "... certain unalienable Rights, that among these are the pursuit of Life, the pursuit of Liberty and the pursuit of Happiness."

it says what it says: " ....certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness."

in a more perfect union everyone would have the same access to life saving medicine.

in short, if i take jefferson at his word: people can be unhappy in a more perfect union. people can't be left to die in a more perfect union.

...at the San Diego Union/Tribune. Until they decided book reviews weren't so necessary. Nice guy, my old roommate was one of his regular reviewers.

Certainly it's not a right as laid out in the constitution, but in this day and age, with the knowledge we have about infectious diseases alone, the lack of publicly funded healthcare for all is most certainly is doing everything BUT promoting the general welfare.

but I have to take exception to the physician's argument that there can be no "right" to something that he cannot personally be compelled to provide. After all, there's a Sixth Amendment right to counsel in criminal cases, even though no particular attorney can be "compelled" to provide representation to any particular person.

which I think was his underlying point. There is no amendment in the constitution that requires the government to provide health care. There is not one that compels education either though if I'm not mistaken and yet we still look at education as something that is universally mandated through our primary years.

though that restrict healthcare and harm people. The insurance companies are monopolies and there isn't a free market. The government is currently protecting those monopolies, and people are dying because of it.

I think it is pretty sick that we allow the insurance companies to profit off the human condition

If the HCR bill wants to give them an administrative fee, that's fine. They can learn then to live within their means and dump the frivolous, overpaid members of the staff whose primary job is to deny benefits, and minimize how much the doctors need to discount services.

but that wasn't the argument. His argument was that he could not personally be compelled to provide health care, and therefore it could not be a right. As for education -- it's not guaranteed by the federal constitution, but it's probably a right under your state constitution.

Just because something isn't spelled out in the Constitution doesn't mean that there can't be law made to cover it. We have a whole host of things the Constitution doesn't cover per se written into law.

It's an conventional and popular point of view, but it's your point of view. In a hundred years, after perhaps legislation, and fifty years or more of health care for all, it'll be unconventional and despised and if you're still alive you'll look back and wonder how you could have been so narrow-minded.

take the Declaration's "life, liberty, and pursuit of hapiness" line...to me that means you have the right to preserve your life in whatever way you yourself are capable, without infringing on anothers life/liberty/pursuit...it doesn't mean you can go to a healthcare provider and demand his/her labor for free.

No one is suggesting we go to a healthcare provider for free. Clearly you don't understand the issues or chose not to.

Private insurance is open as an option to anyone that wants it. Public option offers healthcare and drugs at affordable prices and healthcare bill under discussion includes cost containment, computerization, and savings that will keep current insane premiums from continuing to rise so that even less citizens can protect themselves.

A good bill provides options and provides incentives for healthy living. Our entire society would benefit hugely considering the immoral profits insurance and drug companies are making while offering limited and often deceptive practices in coverage.

We are bankrupting our citizens who when faced with catastrophic illness, cannot deal with uncovered drug and insurance costs. This is happening to hard working,prudent people every day. Even Medicare has deductibles and 20% of uncovered medical expenses, etc.

I blame our current leadership for not making this and all specifics crystal clear. Has anyone ever heard of power point?

...that's their choice. And the doctor is right to assert it. Presumably doctors, like all professions, provide rewards beyond monetary compensation. Professionals need to make a living of course and if the pay for being a doctor ends up being too low for some of them, I say good riddens. I'd rather have a doctor that was a doctor because he believed his gifts and learning and ability to heal were their own rewards. I wish I had the temperament and discipline to actually cure disease and heal the sick. What higher reward could there be? I've had the good fortune to have health care professionals that were motivated by their belief that life itself was compelling. Maybe I've been lucky. Maybe most doctors do it for the money. If so, maybe that's what's wrong with our healthcare system. But I doubt it.

Doctor doesn't want to cure or heal somebody because they can't pay? He's a bad doctor.

I'm not saying we shouldn't reform and attempt to improve the healthcare system and make sure quality care is available and affordable to all...a noble goal, to be sure. The best way to go about it beats me...the insurance co's and the government in their current incarnations both scare me and I expect both to screw me...but only government has the power to make law and regulate behavior...an added little scare.

I was just stating, by my interpretation of inalienable rights and constitutional rights, the right to healthcare does not exist...its a good idea and something any compassionate society should do, but it's not a right. Not one you can defend anyway, which when push comes to shove are the only ones ya got.

though if not a right. There a great book out called The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care (Hardcover)
by T.R. Reid

The author traveled the globe to get to know the 4 or 5 major health cares in the world. England, France, Germany, Japan, India, etc. He also had his war injury looked at by each form. The advice he got from each different country was very interesting. From a complete shoulder replacement to learning how to live with a not so perfect shoulder.

Taiwan became a wealth country in 15 years. They felt since they had become so well off it was an moral obligation to have health care for all. Their were politicians very much against it but the overwhelming majority were for it so it was passed.

I did not know that the Canadian health care system was called Medicare. Johnson borrowed the name for his program.

He claims the U.S. has all 4 or 5 major forms of health care and should have one public one. The amount of money spent on the administration of the U.S. health care is enormous while most other countries use only 2 to 3 percent to adminster their program

The U.S. is one of the richest country in the world. They should follow Taiwan example. Its a moral obligation

I heard that "it's in the preamble" argument on one of the Air America shows last week and it almost had me, but in the end I think it's a stretch.

I think it is a moral imperative and mark of a civil society that we legislate emergency care, and possibly health care for all, but honestly, the 'health care is a right' argument, whether constitutional or human right, is one that I have yet to hear articulated in a convincing way. Certainly we all have the right not to have our health actively diminished by the acts of others, but I don't know where a 'right to health care' comes from.

Apparently you don't think the pursuit of happiness means wellness. A lack of unnecessary suffering? A life shortened by an absence of medical help? An absence of pain that could be alleviated or cured by surgery or drugs?

You don't think the pursuit of happiness is
being well?

You can parse this forever but common humanity towards ourselves and fellow citizens is a given as part of the ten commandments.

There's no right in the Constitution to have the government enforce property rights or contract rights. Trespass laws are not required under the U.S. Constitution. There's also no right in the Constitution to have the government make it illegal for someone to kill you.

James Madison's view of the General Welfare Clause of Article 1. Section 8. This response is from a letter written to Edmund Pendleton on January 21, 1792;

"Having not yet succeeded in hitting on an opportunity, I send you a part of it in a newspaper, which broaches a new Constitutional doctrine of vast consequence, and demanding the serious attention of the public. I consider it myself as subverting the fundamental and characteristic principle of the Government; as contrary to the true and fair, as well as the received construction, and as bidding defiance to the sense in which the Constitution is known to have been proposed, advocated, and adopted. If Congress can do whatever in their discretion can be done by money, and will promote the General Welfare, the Government is no longer a limited one, possessing enumerated powers, but an indefinite one, subject to particular exceptions. It is to be remarked that the phrase out of which this doctrine is elaborated is copied from the old Articles of Confederation, where it was always understood as nothing more than a general caption to the specified powers."

if number 1) isn't a right then neither is liberty or pursuit of happiness.

so here's my question. was slavery unconstitutional?? apparently the people who wrote the constitution didn't think so. so that's about as much as i value those "what did the framer's think?" debates.

i'm no constitutional scholar and the words can mean anything to anyone at any given point in time, but i see no reason why a government can't compel a doctor to treat someone for less money, because being a doctor is a priveledge too, not a right. and if doctors are still being paid better than 98% of all the other jobs that exist in our society then i don't want to hear about incentives and there being no doctors and all that either.

Conservatives have argued for decades that we have no right to privacy, or choice, and now health care because it's not mentioned in the Constitution. Apparently in their fixation on the Tenth Amendment, they've skipped over the one before it. Here's the Ninth Amendment in its entirety:

"The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people."

This is as plain as it can be: the absence of an enumerated right in the Constitution is not grounds for denying its existence. In all the arguments over whether the Constitution guarantees certain rights, I have never heard anyone cite the Ninth. Are we possibly overlooking something here?

One can't even worry about their healthcare if they can't feed themselves and find a place to sleep.

One need only go to work and pass a homeless person to figure out that our constitution doesn't garuntee food and shelter.

Why would it skip those essentials and move onto healthcare?

For the sake of arguement lets say it does garuntee healthcare. What kind?

Does a sick child have a "right" to the latest cutting edge procedure? The latest drug, implant or miracle cure? When in the evolution of a medical discovery does it become a right to all americans? Who decides and how do we pay for it?

are the baseline. It's exactly what was meant by "life" in the phrase life, liberty, and the pursuit of happiness. Life is physical, fundamental. Liberty is subtle, and builds on the foundation of life. And at last, not happiness, but the pursuit of happiness, the right to seek enlightenment. A legalistic reading that defines these self-evident truths down is deviant.

if the right to life included food/shelter/clothing, wouldn't we all be endowed by our creator with food/shelter/clothing like we are endowed with life and liberty?

Again, don't get me wrong, I'm all for taking on a moral obligation to feed/shelter/cloth those who cannot provide for themselves...but to call it a right just is not reality-based. You have the inalienable right to find food, make shelter, make clothing, protect your liberty and pursue your happiness...that in no way means you have the right to have all of it placed in your lap.